Nasal Continuous Positive Airway Pressure

Nasal CPAP treatment has been used in the initial description of UARS (2). It was demonstrated that CPAP was able to resolve inspiratory flow limitation by increasing the upstream pressure. Sleepiness as assessed by the multiple sleep latency test (MSLT) was also significantly improved. However, in this patient sample as well as in samples which followed (55,61,62) adherence with CPAP treatment continues to be a problem. Sleep-onset insomnia may be an important factor for this low adherence in that inspiratory load compensation at sleep onset may not be the only reason for the development of sleep instability at sleep onset. The addition of the therapeutic interface may add to sleep-onset disturbance and aggravate sleep-maintenance insomnia.

Despite the limited adherence with CPAP in the treatment of UARS, it still constitutes the first line of treatment. Side effects are limited and, unlike surgery, CPAP does not result in potential side effects that are nonreversible. The advantage of a CPAP trial is that in some patients it can yield additional diagnostic information by resolving daytime sleepiness.

Sleep Apnea

Sleep Apnea

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